Total knee arthroplasty and femoral osteotomy with a patient-specific cutting guide to treat haemophilic arthritis with severe extra-articular deformity: A case report and review of literatures
BackgroundTotal knee arthroplasty (TKA) is recommended for haemophilic patients with end-stage arthritis. TKA combined with a one-stage extraarticular osteotomy is uncommon in the treatment of haemophilic arthritis (HA) with severe extra-articular deformities (EADs) and a history of inhibitors under...
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Frontiers Media S.A.
2023-01-01
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| Series: | Frontiers in Surgery |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fsurg.2022.1067306/full |
| _version_ | 1797960057586974720 |
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| author | Shuai-Jie Lv Zheng-Ming Wang Rui Wang Heng-Kai Jin Pei-Jian Tong Xun Liu |
| author_facet | Shuai-Jie Lv Zheng-Ming Wang Rui Wang Heng-Kai Jin Pei-Jian Tong Xun Liu |
| author_sort | Shuai-Jie Lv |
| collection | DOAJ |
| description | BackgroundTotal knee arthroplasty (TKA) is recommended for haemophilic patients with end-stage arthritis. TKA combined with a one-stage extraarticular osteotomy is uncommon in the treatment of haemophilic arthritis (HA) with severe extra-articular deformities (EADs) and a history of inhibitors under the guidance of a patient-specific cutting guide (PSI).Case presentationWe reported a 20-year-old male patient with severe haemophilia, limited knee functionality, a 30° sagittal deformity on the femoral side and a history of inhibitors. We adopted the Van Creveld protocol to decrease the inhibitors. TKA and extra-articular osteotomy (EAO) were performed simultaneously and sequentially under the guidance of PSI. An appropriate central alignment of the lower limb was restored by using cement prostheses with antibiotics and femur shaft locking compression plates. The last follow-up showed that the knee function was good, the VAS score was 0, the WOMAC score was 18 and the ROM was 0°–95°.ConclisionRegular haematology management can reduce the perioperative bleeding risk in haemophilic patients treated with inhibitors. PSI plays an important role in guiding the TKA and EAO of end-stage HA patients with severe EAD. |
| first_indexed | 2024-04-11T00:40:03Z |
| format | Article |
| id | doaj.art-3cb53141cd694e44a827af2b3e27e1b7 |
| institution | Directory Open Access Journal |
| issn | 2296-875X |
| language | English |
| last_indexed | 2024-04-11T00:40:03Z |
| publishDate | 2023-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Surgery |
| spelling | doaj.art-3cb53141cd694e44a827af2b3e27e1b72023-01-06T07:15:04ZengFrontiers Media S.A.Frontiers in Surgery2296-875X2023-01-01910.3389/fsurg.2022.10673061067306Total knee arthroplasty and femoral osteotomy with a patient-specific cutting guide to treat haemophilic arthritis with severe extra-articular deformity: A case report and review of literaturesShuai-Jie Lv0Zheng-Ming Wang1Rui Wang2Heng-Kai Jin3Pei-Jian Tong4Xun Liu5Orthopedics and Traumatology, The First Affiliated Hospital of Zhejiang Chinese Medical University(Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, ChinaShi's Center of Orthopedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, ChinaThe First School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, ChinaThe First School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, ChinaOrthopedics and Traumatology, The First Affiliated Hospital of Zhejiang Chinese Medical University(Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, ChinaOrthopedics and Traumatology, The First Affiliated Hospital of Zhejiang Chinese Medical University(Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, ChinaBackgroundTotal knee arthroplasty (TKA) is recommended for haemophilic patients with end-stage arthritis. TKA combined with a one-stage extraarticular osteotomy is uncommon in the treatment of haemophilic arthritis (HA) with severe extra-articular deformities (EADs) and a history of inhibitors under the guidance of a patient-specific cutting guide (PSI).Case presentationWe reported a 20-year-old male patient with severe haemophilia, limited knee functionality, a 30° sagittal deformity on the femoral side and a history of inhibitors. We adopted the Van Creveld protocol to decrease the inhibitors. TKA and extra-articular osteotomy (EAO) were performed simultaneously and sequentially under the guidance of PSI. An appropriate central alignment of the lower limb was restored by using cement prostheses with antibiotics and femur shaft locking compression plates. The last follow-up showed that the knee function was good, the VAS score was 0, the WOMAC score was 18 and the ROM was 0°–95°.ConclisionRegular haematology management can reduce the perioperative bleeding risk in haemophilic patients treated with inhibitors. PSI plays an important role in guiding the TKA and EAO of end-stage HA patients with severe EAD.https://www.frontiersin.org/articles/10.3389/fsurg.2022.1067306/fullhaemophilic arthritisextra-articular deformityPSItotal knee arthroplastycase report |
| spellingShingle | Shuai-Jie Lv Zheng-Ming Wang Rui Wang Heng-Kai Jin Pei-Jian Tong Xun Liu Total knee arthroplasty and femoral osteotomy with a patient-specific cutting guide to treat haemophilic arthritis with severe extra-articular deformity: A case report and review of literatures Frontiers in Surgery haemophilic arthritis extra-articular deformity PSI total knee arthroplasty case report |
| title | Total knee arthroplasty and femoral osteotomy with a patient-specific cutting guide to treat haemophilic arthritis with severe extra-articular deformity: A case report and review of literatures |
| title_full | Total knee arthroplasty and femoral osteotomy with a patient-specific cutting guide to treat haemophilic arthritis with severe extra-articular deformity: A case report and review of literatures |
| title_fullStr | Total knee arthroplasty and femoral osteotomy with a patient-specific cutting guide to treat haemophilic arthritis with severe extra-articular deformity: A case report and review of literatures |
| title_full_unstemmed | Total knee arthroplasty and femoral osteotomy with a patient-specific cutting guide to treat haemophilic arthritis with severe extra-articular deformity: A case report and review of literatures |
| title_short | Total knee arthroplasty and femoral osteotomy with a patient-specific cutting guide to treat haemophilic arthritis with severe extra-articular deformity: A case report and review of literatures |
| title_sort | total knee arthroplasty and femoral osteotomy with a patient specific cutting guide to treat haemophilic arthritis with severe extra articular deformity a case report and review of literatures |
| topic | haemophilic arthritis extra-articular deformity PSI total knee arthroplasty case report |
| url | https://www.frontiersin.org/articles/10.3389/fsurg.2022.1067306/full |
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